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Women and Arrhythmias

By Hope B. Helfeld, DO FACC

Cardiac arrhythmias (heart rhythm abnormalities) are heart rhythm abnormalities and electrophysiologists are cardiologist that specialize in heart rhythm disorders. There are no arrhythmias that are specific to women. However, women have distinct symptoms, different causes and frequencies of arrhythmias, and even differing outcomes with treatment of arrhythmias compared with men. This article will discuss arrhythmias and their effect on women.
Palpitations are a very common complaint and may be the first symptoms of an arrhythmia. It can feel like a thump in your chest, or a racing heart beat. Some possible causes of palpitations can be:

  • Isolated extra beats coming from the top of the heart (premature atrial complexes, "PACs"), or the bottom of the heart (premature ventricular complexes, "PVCs").
  • A sustained, (longer lasting), rapid heart beat that originates from the upper chambers of the heart.
    o Supraventricular Tachycardia, (SVT).
    o Atrial Fibrillation, (AF).
  • A rapid heart rate that originates from the lower chambers of the heart
    o Ventricular Tachycardia, (VT).

Sometimes, a sensation of palpitations occurs and no arrhythmia is detected. This may be due to other factors such as stress or emotional disorders. However, in such circumstances, it is essential that a thorough evaluation be performed by your physician to rule out any possibility of a physical cause.

There is no real gender difference for the overall occurrence of palpitations. It is important to remember that palpitations are a symptom of an arrhythmia and not a diagnosis. Therefore it is important to identify the cause of the palpitations, determine what risk that cause presents for the individual and discuss treatment strategies with your physician.

What are some differences then?
Men and women can both develop one of the SVT type of arrhythmias. However, women are twice as likely as men to have a type of SVT called AV nodal reentry tachycardia (AVNRT), the most common type of SVT.

In contrast, men are two times more likely than women to have AV reentry tachycardia, or SVTs that occur due to a congenital accessory pathway. The reasons for these differences are unclear. Several studies have found that women have an increased incidence of SVT episodes during the certain phases of their menstrual cycle and during peri-menopause.

Atrial Fibrillation (AF) is probably the most common arrhythmia. Your risk for developing AF increases with age. It leads to substantial morbidity and mortality because of the risk of stroke associated with it. Studies have shown that woman with AF have a higher risk of dying compared with their male counterparts. Women tended to have faster heart rates during episodes of AF and the episodes lasted longer.

The QT interval is one of the biggest gender-specific differences that can be identified for arrhythmias. It is one of several measurements captured on an electrocardiogram, (EKG), and measures the amount of the it takes for the heart to repolarize (recover electrically from each heart beat). From birth through puberty, males and females have equally long QT intervals. At puberty males shorten their QT intervals. Females fail to shorten, leaving them with longer QT. Abnormally prolonged QT intervals can lead to life threatening arrhythmias. This can be something a person is born with (congenital Long QT) or it can be acquired due to illness or medication effects.

These are a few of the differences between men and women in regards to arrhythmias. Meet with our electrophysiologist to learn more about arrhythmias in women.

Last Updated: 6/1/2011